2011～2014年阴道分娩产妇会阴侧切状况调查  

Survey on lateral episiotomy among puerperal women receiving vaginal delivery from 2011 to 2014

作　　者：梁礼莉[1] 闵丽华[1] 李宁蔚[1] 

机构地区：[1]四川省人民医院,四川成都610072

出　　处：《中国妇幼保健》2015年第7期1087-1089,共3页Maternal and Child Health Care of China

摘　　要：目的：对2011-2014年成都市青羊区经阴道分娩产妇的会阴侧切状况进行调查分析,了解会阴侧切的比例及原因,为降低会阴侧切率提供原始资料。方法：按照医院级别、产科床位数进行分层等比例对辖区内17所医院进行抽样调查,其中三级医院2家、二级及其他类型医院15家,2011-2014年每年分别抽取2 000例阴道分娩产妇的临床病历资料,对产妇的一般信息及住院信息进行统计分析。结果：2011-2014年会阴侧切率逐年显著增高,4年间会阴侧切率比较差异具有统计学意义（χ2=102.953,P〈0.05）,4年间抽样的8 00例产妇中共计3 00例产妇进行会阴侧切（41.25%）。18-30岁组产妇的会阴侧切率48.44%显著高于31-42岁组产妇的27.08%（P〈0.08）。农村户籍产妇的会阴侧切率39.90%显著低于城镇产妇的会阴侧切率42.59%（P〈0.05）。初产妇的会阴侧切率为43.17%显著高于经产妇的37.63%（P〈0.05）。2011-2014年的3 00例会阴侧切产妇中有1 432例产妇无明确的会阴侧切手术指征（占会阴侧切产妇的43.39%）;会阴侧切组中主要指征分别为会阴过紧（17.21%）、胎儿〉3 500 g（20.33%）。结论：运用综合有效手段加强对产妇会阴的管理,严格掌握会阴侧切的指征,降低会阴侧切率,减轻产妇分娩损伤,减少产后并发症。Objective： To survey and analyze lateral episiotomy among puerperal women receiving vaginal delivery in Qingyang District of Chengdu from 2011 to 2014, understand the proportion and causes of lateral episiotomy, and provide original data for reducing lateral episiotomy rate. Methods： Seventeen hospitals were surveyed by stratified sampling method according to hospital level and the number of obstetrical department, 2 thirdlevel hospitals and 15 secondlevel hospitals and other types of hospitals were included. From 2011 to 2014, the clinical data of 2 000 puerperal women receiving vaginal delivery were abstracted each year, the general information and hospitali- zation information were analyzed statistically. Results： The lateral episiotomy rate from 2011 to 2014 increased significantly year by year, there was statistically significant difference among different years （x^2 = 102. 953, P 〈 0. 05 ） ; among 8 000 puerperal women, 3 000 puerperal women （41.25%） underwent lateral episiotomy. The lateral episiotomy rate among puerperal women aged 18 - 30 years old was 48.44%, which was statistically significantly higher than that among puerperal women aged 31 - 42 years old （27.08%） （P 〈 0. 08） . The lateral episiotomy rate among rural puerperal women was 39.90%, which was statistically significantly lower than that among urban puerperal women （42. 59% ） （P 〈0.05） . The lateral episiotomy rate among primiparous women was 43. 17% , which was statistically significantly higher than that among multiparous women （37. 63% ） （ P 〈 0. 05 ） . Among 3 000 puerperal women receiving lateral episiotomy from 2011 to 2014, 1 432 puerperal women had no obvious indications for lateral episiotomy, accounting for 43.39% ; the main indications for lateral episiotomy included tight perineum （ 17.21% ） and fetal weight 〉 3 500 g （20. 33% ） Conclusion： Strengthening perineal management comprehensively and effectively and controlling indicatioris of lateral episiotomy stricily can redu

关 键 词：阴道分娩 会阴侧切 指征 

分 类 号：R714[医药卫生—妇产科学]